Skip to main content
SpringerLink
Log in

Ocular Parasitic Infections

  • Chapter
Uveitis: An Update

  • 1318 Accesses

Abstract

Ocular parasitology is the study of parasites that infect humans and result in ocular complications. Complications occur either due to mechanical, immunologic, or allergic reactions [1]. Because of protean manifestations and lack of clinical suspicion, the diagnosis is often missed. Prior to making a final diagnosis, ophthalmologists have to get dietary history, as most parasitic transmission is through food and water contamination. Travel history to endemic areas is important to determine the source of infection. When the humans are not the definitive hosts, but play the role of an accidental or intermediate host, the parasites do not mature into adult worms. Eggs or cysts are seldom found on stool examination. It is important for the ophthalmologists to understand the life cycle of the worm to select proper diagnostic tests (Table 13.1). Construction of an algorithm regarding management of ocular parasites is mandatory (Fig. 13.1). Sometimes patient may have associated systemic infestation (Fig. 13.2a, b). Careful systemic examination can aid in comprehensive treatment. There are several agents that can affect different ocular structures; clinical signs depend on the location and type of organism (Table 13.2).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Otranto D, Eberhard ML. Zoonotic helminths affecting the human eye. Parasit Vectors. 2011;4:41.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Nimir AR, Saliem A, Ibrahim IAA. Ophthalmic parasitosis: a review article. Interdiscip Perspect Infect Dis. 2012; http://dx.doi.org/10.1155/2012/587402.

  3. Molyneux D, Hallaj Z, Keusch GT, et al. Zoonoses and marginalised infectious diseases of poverty: where do we stand? Parasit Vectors. 2011;4:106.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Rathinam SR, Ashok K. Ocular manifestations of systemic disease: ocular parasitosis. Curr Opin Ophthalmol. 2011;21:478–84.

    Article  Google Scholar 

  5. Sow S, de Vlas SJ, Mbaye A, et al. Low awareness of intestinal schistosomiasis in northern Senegal after 7 years of health education as part of intense control and research activities. Trop Med Int Health. 2003;8:744–9.

    Article  PubMed  Google Scholar 

  6. Yirga D, Deribe K, Woldemichael K, et al. Factors associated with compliance with community directed treatment with ivermectin for onchocerciasis control in Southwestern Ethiopia. Parasit Vectors. 2010;3:48.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Rathinam SR. Treating uveitis in the developing world setting. Int Ophthalmol Clin. 2010;50:219–28.

    Article  PubMed  Google Scholar 

  8. Rathinam SR, Annamalai R, Biswas J. Intraocular parasitic infections. OculImmunol Inflamm. 2011;19:327–36.

    CAS  Google Scholar 

  9. Pahuja S, Puranik C, Jelliti B, et al. Parasitic infections of the external eye. OculImmunol Inflamm. 2013;21:292–9.

    Google Scholar 

  10. Hom MM, Mastrota KM, Schachter SE. Demodex. Optom Vis Sci. 2013;90:e198–205.

    Article  PubMed  Google Scholar 

  11. Filho PA, Hazarbassanov RM, Grisolia AB, et al. The efficacy of oral ivermectin for the treatment of chronic blepharitis in patients tested positive for Demodex spp. Br J Ophthalmol. 2011;95:893–5.

    Article  PubMed  Google Scholar 

  12. Sucilathangam G1, Meenakshisundaram A, Hariramasubramanian S. External ophthalmomyiasis which was caused by sheep botfly (oestrus ovis) larva: a report of 10 cases. J Clin Diagn Res. 2013;7:539–42.

    Google Scholar 

  13. Abdellatif MZM, Elmazar HMF, Essa AB. Oestrus ovis as a cause of red eye in Aljabal Algharbi, Libya. Middle East Afr J Ophthalmol. 2011;18:305–8.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Vijayalekshmi S, Shukla H. Unilateral acute conjunctivitis due to Oestrus ovis in a veterinary doctor. J Nat Sci Biol Med. 2013;4:2283–30.

    Article  Google Scholar 

  15. Maurya RP, Mishra D, Bhushan P, et al. Orbital myiasis: due to invasion of larvae of flesh fly (wohlfahrtia magnifica) in a child; rare presentation. Case Rep Ophthalmol Med. 2012;2012:371498.

    PubMed Central  CAS  PubMed  Google Scholar 

  16. Chiapella KJ. Verminous ophthalmia. West J Med. 1974;120:500.

    PubMed Central  CAS  PubMed  Google Scholar 

  17. Otranto D, Traversa D. Thelaziaeyeworm: an original endo- and ecto-parasitic nematode. Trends Parasitol. 2005;21:1–4.

    Article  PubMed  Google Scholar 

  18. Shen J, Gasser RB, Chu D, et al. Human thelaziosis – a neglected parasitic disease of the eye. J Parasitol. 2006;92:872–5.

    Article  PubMed  Google Scholar 

  19. Sharma S, Pasricha G, Das D. Acanthamoeba keratitis in non-contact lens wearers in India: DNA typing-based validation and a simple detection assay. Arch Ophthalmol. 2004;122:1430–4.

    Article  PubMed  Google Scholar 

  20. Corsi A, Nucci C, Knafelz D, et al. Ocular changes associated with Giardia lamblia infection in children. Br J Ophthalmol. 1998;2:59–562.

    Article  Google Scholar 

  21. Rippon JW, Varadi DP. The elastases of pathogenic fungi and actinomycetes. J Invest Dermatol. 1968;50:54–8.

    CAS  PubMed  Google Scholar 

  22. Herr RA, Ajello L, Taylor JW. Phylogenetic analysis of Rhinosporidium seeberi’s 18S small-subunit ribosomal DNA groups this pathogen among members of the protoctistan Mesomycetozoa clade. J Clin Microbiol. 1999;37:2750–4.

    PubMed Central  CAS  PubMed  Google Scholar 

  23. Morelli L, Polce M, Piscioli F, et al. Human nasal rhinosporidiosis: an Italian case report. Diagn Pathol. 2006;1:25.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Yokoi K, Goto H, Sakai JI, et al. Clinical features of ocular toxocariasis in Japan. OculImmunol Inflamm. 2003;11:269–75.

    Google Scholar 

  25. Rubinsky-Elefant G, Hirata CE, Yamamoto JH, et al. Human toxocariasis: diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms. Ann Trop Med Parasitol. 2010;104:3–23.

    Article  CAS  PubMed  Google Scholar 

  26. Cortez RT, Ramirez G, Collet L. Ocular parasitic diseases: a review on toxocariasis and diffuse unilateral subacute neuroretinitis. J Pediatr Ophthalmol Strabismus. 2011;48(4):204–12.

    Article  PubMed  Google Scholar 

  27. Gems D, Maizels RM. An abundantly expressed Mucin-like protein from Toxocara Canis Infective Larvae: the precursor of the larval surface coat glycoproteins. Proc Natl Acad Sci U S A. 1996;93:1665–70.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Tran VT, Lumbroso L, LeHoang P, et al. Ultrasound biomicroscopy in peripheral retinovitreal toxocariasis. Am J Ophthalmol. 1999;127:607–9.

    Article  CAS  PubMed  Google Scholar 

  29. Wittenberg LA, Maberley DA, Patrick E, et al. Contribution of vitreous cytology to final clinical diagnosis. Ophthalmology. 2008;115:1944–50.

    Article  PubMed  Google Scholar 

  30. Chieffi PP, Santos SV, Queiroz ML, et al. Human toxocariasis: contribution by Brazilian researchers. Rev Inst Med Trop Sao Paulo. 2009;51:301–8.

    Article  PubMed  Google Scholar 

  31. Hotez PJ, Wilkins PP. Toxocariasis: America’s most common neglected infection of poverty and a helminthiasis of global importance. PLoS Negl Trop Dis. 2009;3:e400.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Barisani-Asenbauer T, Maca SM, Hauff W, et al. Treatment of ocular toxocariasis with albendazole. J Ocul Pharmacol Ther. 2001;17:287–94.

    Article  CAS  PubMed  Google Scholar 

  33. Barrera MG, Leonardi D, Bolmaro RE, et al. In vivo evaluation of albendazole microspheres for the treatment of Toxocaracanis larva migrans. Eur J Pharm Biopharm. 2010;75:451–4.

    Article  CAS  PubMed  Google Scholar 

  34. Taylor HR, Nutman TB. Onchocerciasis. In: Pepose JS, Holland GN, Wilhelmus KR, editors. Ocular infection and immunity. Mosby: St. Louis; 1996. p. 1481–504.

    Google Scholar 

  35. Ali MM, Baraka OZ, AbdelRahman SI, et al. Immune responses directed against microfilariae correlate with severity of clinical onchodermatitis and treatment history. J Infect Dis. 2003;187:714–7.

    Article  PubMed  Google Scholar 

  36. Korten S, Kaifi JT, Büttner DW. Transforming growth factor-beta expression by host cells is elicited locally by the filarial nematode Onchocerca volvulus in hyporeactive patients independently from Wolbachia. Microbes Infect. 2010;12:555–64.

    Article  CAS  PubMed  Google Scholar 

  37. Saint André A, Blackwell NM, Hall LR, et al. The role of endosymbiotic Wolbachia bacteria in the pathogenesis of river blindness. Science. 2002;295:1892–5.

    Article  PubMed  Google Scholar 

  38. Taylor HR. Mazzotti test for onchocerciasis. Lancet. 1992;339:1549–50.

    Article  CAS  PubMed  Google Scholar 

  39. Ozoh G, Boussinesq M, Bissek AZ, et al. Evaluation of the diethylcarbamazine patch to evaluate onchocerciasis endemicity in Central Africa. Trop Med Int Health. 2007;12:123–9.

    PubMed  Google Scholar 

  40. Rodríguez-Pérez MA, Domínguez-Vázquez A, Méndez-Galván J, et al. Antibody detection tests for Onchocerca volvulus: comparison of the sensitivity of a cocktail of recombinant antigens used in the indirect enzyme-linked immunosorbent assay with a rapid-format antibody card test. Trans R Soc Trop Med Hyg. 2003;97:539–41.

    Article  PubMed  Google Scholar 

  41. Ayong LS, Tume CB, Wembe FE, et al. Development and evaluation of an antigen detection dipstick assay for the diagnosis of human onchocerciasis. Trop Med Int Health. 2005;10:228–33.

    Article  CAS  PubMed  Google Scholar 

  42. Boatin BA, Toé L, Alley ES, et al. Diagnostics in onchocerciasis: future challenges. Ann Trop Med Parasitol. 1998;92:S41–5.

    Article  PubMed  Google Scholar 

  43. Taylor HR, Murphy RP, Newland HS, et al. Treatment of onchocerciasis. The ocular effects of ivermectin and diethylcarbamazine. Arch Ophthalmol. 1986;104:863–70.

    Article  CAS  PubMed  Google Scholar 

  44. Lui L, Weller P. Antiparasitic drugs. N Engl J Med. 1996;334:1178–84.

    Article  Google Scholar 

  45. Hoerauf A, Specht S, Büttner M, et al. Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study. Med Microbiol Immunol. 2008;197:295–311.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  46. Murdoch ME. Onchodermatitis. Curr Opin Infect Dis. 2010;23:124–31.

    Article  PubMed  Google Scholar 

  47. Bhedasgaonkar S, Baile RB, Nadkarni S, et al. Loa loa macrofilariasis in the eyelid: case report of the first periocular subcutaneous manifestation in India. J Parasit Dis. 2011;35:230–1.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Bowler GS, Shah AN, Bye LA, et al. Ocular loiasis in London 2008–2009: a case series. Eye (Lond). 2011;25:389–91.

    Article  CAS  Google Scholar 

  49. Antinori S, Schifanella L, Million M, et al. Imported Loa loa filariasis: three cases and a review of cases reported in non-endemic countries in the past 25 years. Int J Infect Dis. 2012;16:e649–62.

    Article  PubMed  Google Scholar 

  50. Passos RM, Barbosa CP, Almeida Jde S, et al. Subconjunctival Loa loa worm: first case report in Brazil. Arq Bras Oftalmol. 2012;75:67–70.

    PubMed  Google Scholar 

  51. Otranto D, Brianti E, Gaglio G, et al. Human ocular infection with Dirofilaria repens (Railliet and Henry, 1911) in an area endemic for canine dirofilariasis. Am J Trop Med Hyg. 2011;84:1002–4.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Sahdev SI, Sureka SP, Sathe PA. Ocular dirofilariasis: still in the dark in western India? J Postgrad Med. 2012;58:227–8.

    Article  CAS  PubMed  Google Scholar 

  53. Pauly M, Biswas J, Hussain RN, et al. Periocular dirofilariasis mimicking lacrimal sac mucocoele. Orbit. 2013;32:324–6.

    Article  PubMed  Google Scholar 

  54. Nath R, Gogoi R, Bordoloi N, et al. Ocular dirofilariasis. Indian J Pathol Microbiol. 2010;53:157–9.

    Article  PubMed  Google Scholar 

  55. Joseph K, Vinayakumar AR, Criton S. Periorbital mass with cellulitis caused by dirofilaria. Indian J Med Microbiol. 2011;29:431–3.

    Article  CAS  PubMed  Google Scholar 

  56. Bhattacharjee H, Das D, Medhi J. Intravitreal gnathostomiasis and review of literature. Retina (Philadelphia, Pa). 2007;27:67–73.

    Article  Google Scholar 

  57. Biswas J, Gopal L, Sharma T, et al. Intraocular gnathostoma spinigerum. Clinicopathologic study of two cases with review of literature. Retina. 1994;14:438–44.

    Article  CAS  PubMed  Google Scholar 

  58. Sen K, Ghose N. Ocular gnathostomiasis. Br J Ophthalmol. 1945;29:618–26.

    Article  PubMed Central  Google Scholar 

  59. Kittiponghansa S, Prabriputaloong A, Pariyanonda S, et al. Intracameral gnathostomiasis: a cause of anterior uveitis and secondary glaucoma. Br J Ophthalmol. 1987;71:618–22.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Bhende M, Biswas J, Gopal L. Ultrasound biomicroscopy in the diagnosis and management of intraocular gnathostomiasis. Am J Phthalmol. 2005;140:140–2.

    Article  Google Scholar 

  61. De Amorim Garcia Filho CA, Gomes AHB, et al. Clinical features of 121 patients with diffuse unilateral subacute neuroretinitis. Am J Ophthalmol. 2012;153:743–9.

    Article  PubMed  Google Scholar 

  62. Oueghlani E, O’Sullivan E, Pavesio CE. Diffuse unilateral subacute neuroretinitis in the United Kingdom. Int Ophthalmol. 2010;30:615–9.

    Article  PubMed  Google Scholar 

  63. Barbazetto IA, Lesser RL, Tom D, et al. Diffuse unilateral subacute neuroretinitis masquerading as a white-dot syndrome. Br J Ophthalmol. 2009;93:574–6. 655.

    Article  CAS  PubMed  Google Scholar 

  64. Anshu A, Chee SP. Diffuse unilateral subacute neuroretinitis. Int Ophthalmol. 2008;28:127–9.

    Article  PubMed  Google Scholar 

  65. Gomes AH, Garcia CA, de Segunda P, et al. Optic coherence tomography in a patient with diffuse unilateral subacute neuroretinitis. Arq Bras Oftalmol. 2009;72:185–8.

    Article  PubMed  Google Scholar 

  66. Casella AM, Farah ME, de Souza EC, et al. Retinal nerve fiber layer atrophy as relevant feature for diffuse unilateral subacute neuroretinitis (DUSN): case series. Arq Bras Oftalmol. 2010;73:182–5.

    Article  PubMed  Google Scholar 

  67. Moraes LR, Cialdini AP, Avila MP, et al. Identifying live nematodes in diffuse unilateral subacute neuroretinitis by using the scanning laser ophthalmoscope. Arch Ophthalmol. 2002;120:135–8.

    Article  PubMed  Google Scholar 

  68. Garcia Filho CA, Soares AC, Penha FM, Garcia CA. Spectral domain optical coherence tomography in diffuse unilateral subacute neuroretinitis. J Ophthalmol. 2011;2011:285296.

    PubMed Central  PubMed  Google Scholar 

  69. Cunha LP, Costa-Cunha LV, Souza EC, et al. Intraretinal worm documented by optical coherence tomography in a patient with diffuse unilateral subacute neuroretinitis: case report. Arq Bras Oftalmol. 2010;73:462–3.

    Article  PubMed  Google Scholar 

  70. Myint K, Sahay K, Mon S, et al. Worm in the eye: the rationale for treatment of DUSN in South India. Br J Ophthalmol. 2006;90:1125–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  71. Gass DM, Callanan G, Bowman CB. Oral therapy in diffuse unilateral subacute neuroretinitis. Arch Ophthalmol. 1992;110:675–80.

    Article  CAS  PubMed  Google Scholar 

  72. Rath S, Honavar SG, Naik M, et al. Orbital cysticercosis: clinical manifestations, diagnosis, management, and outcome. Ophthalmology. 2010;117:600–5.

    Article  PubMed  Google Scholar 

  73. Prasad KN, Prasad A, Verma A, et al. Human cysticercosis and Indian scenario: a review. J Biosci. 2008;33:571–82.

    Article  PubMed  Google Scholar 

  74. Li JJ, Zhang LW, Li H, et al. Clinical and pathological characteristics of intraocular cysticercosis. Korean J Parasitol. 2013;51:223–9.

    Article  PubMed Central  PubMed  Google Scholar 

  75. Wender JD, Rathinam SR, Shaw RE. Intraocular cysticercosis: case series and comprehensive review of the literature. Ocul Immunol Inflamm. 2011;19:240–5.

    Article  PubMed  Google Scholar 

  76. Mahendradas P, Biswas J, Khetan V. Fibrinous anterior Uveitis due to Cysticercus cellulosae. Ocul Immunol Inflamm. 2007;15:451–4.

    Article  CAS  PubMed  Google Scholar 

  77. Ratra D, Phogat C, Singh M, et al. Intravitreal cysticercosis presenting as neovascular glaucoma. Indian J Ophthalmol. 2010;58:70–3.

    Article  PubMed Central  PubMed  Google Scholar 

  78. Del Brutto OH, Rajshekhar V, White Jr AC, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology. 2001;24:177–83.

    Article  Google Scholar 

  79. Abba K, Ramaratnam S, Ranganathan LN. Anthelmintics for people with neurocysticercosis. Cochrane Database Syst Rev. 2010;(1):CD000215.

    Google Scholar 

  80. Deckers N, Dorny P. Immunodiagnosis of taenia solium taeniosis/cysticercosis. Trends Parasitol. 2010;26:137–44.

    Article  CAS  PubMed  Google Scholar 

  81. Ogunremi O, Benjamin J. Development and field evaluation of a new serological test for Taenia saginata cysticercosis. Vet Parasitol. 2010;169:93–101.

    Article  PubMed  Google Scholar 

  82. Lightowlers MW. Eradication of Taenia solium cysticercosis: a role for vaccination of pigs. Int J Parasitol. 2010;15:1183–92.

    Article  Google Scholar 

  83. Williams DF, Williams GA, Caya JG, et al. Intraocular Echinococcus multilocularis. Arch Ophthalmol. 1987;105:1106–9.

    Article  CAS  PubMed  Google Scholar 

  84. Ozek MM, Pamir MN, Sav A. Spontaneous rupture of an intraorbital hydatid cyst. A rare cause of acute visual loss. J Clin Neuroophthalmol. 1993;13:135–7.

    Article  CAS  PubMed  Google Scholar 

  85. Rathinam S, Fritche TR, Srinivasan M, et al. An outbreak of trematode-induced granulomas of the conjunctiva. Ophthalmology. 2001;108:1223–9.

    Article  CAS  PubMed  Google Scholar 

  86. Rathinam SR, Usha KR, Rao NA. Presumed Trematode-induced Granulomatous Anterior Uveitis: a newly recognized cause of intraocular inflammation in children from South India. Am J Ophthalmol. 2002;133:773–9.

    Article  PubMed  Google Scholar 

  87. Rathinam SR, Arya LK, Usha KR, et al. Novel etiological agent: molecular evidence for trematode-induced anterior uveitis in children. Arch Ophthalmol. 2012;130:1481–4.

    Article  PubMed  Google Scholar 

  88. Umadevi K, Madhavi R. Observations on the morphology and life-cycle of Procerovum varium (Onji & Nishio, 1916) (Trematoda: Heterophyidae). Syst Parasitol. 2000;46:215–25.

    Article  CAS  PubMed  Google Scholar 

  89. Hyder AA, Corluka A, Winch PJ. National policy-makers speak out: are researchers giving them what they need? Health Policy Plan. 2011;26:73–82.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Financial Support

Aravind Medical Research Foundation & Defense Research and Development Establishment (DRDE), Gwalior.

Author information

Authors and Affiliations

  1. Uveitis Service, Aravind Eye Hospital and PG Institute of Ophthalmology, 1, Anna Nagar, Madurai, Tamil Nadu, 625 020, India

    S. R. Rathinam FAMS, PhD

  2. Department of Ophthalmology, Kasturba Medical College, Manipal, Udupi District, Karnataka, India

    Yogish Kamath MS

Authors
  1. S. R. Rathinam FAMS, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yogish Kamath MS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. R. Rathinam FAMS, PhD .

Editor information

Editors and Affiliations

  1. Uveitis and Ocular Pathology Department, Sankara Nethralaya, Chennai, India

    Jyotirmay Biswas

  2. Department of Uvea and Intraocular Inflammation, Sankara Nethralaya, Chennai, India

    Parthopratim Dutta Majumder

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer India

About this chapter

Cite this chapter

Rathinam, S.R., Kamath, Y. (2016). Ocular Parasitic Infections. In: Biswas, J., Majumder, P. (eds) Uveitis: An Update. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2295-8_13

Download citation

  • DOI: https://doi.org/10.1007/978-81-322-2295-8_13

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-2294-1

  • Online ISBN: 978-81-322-2295-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation